Reproductive medicine is a branch of medicine that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health and allowing people to have children at a time of their choosing. It is founded on knowledge of reproductive anatomy, physiology, and endocrinology, and incorporates relevant aspects of molecular biology, biochemistry and pathology.
Scope
Reproductive medicine addresses issues of sexual education, puberty, family planning, birth control, infertility, reproductive system disease (including sexually transmitted diseases) and sexual dysfunction.[1] In women, reproductive medicine also covers menstruation, ovulation, pregnancy and menopause, as well as gynecologic disorders that affect fertility.[2]
The field cooperates with and overlaps mainly with reproductive endocrinology and infertility, sexual medicine and andrology, but also to some degree with gynecology, obstetrics, urology, genitourinary medicine, medical endocrinology, pediatric endocrinology, genetics, and psychiatry.
Methods
Assessment methods could include: imaging techniques, laboratory methods and reproductive surgery.[3] Treatment methods include counseling, pharmacology (e.g. fertility medication), surgery, and other methods. In vitro fertilization has evolved as a major treatment modality[4] that has enabled the study of the embryo prior to implantation.
Education and training
Specialists in reproductive medicine usually undergo training in obstetrics and gynecology followed by training in reproductive endocrinology and infertility, or in urology followed by training in andrology. For reproductive medicine specialists in contraception, other methods of training are possible. Specialists tend to be organized in specialty organizations such as the American Society for Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology (ESHRE).[5]
Anamnesis
The anamnesis or medical history taking of issues related to reproductive or sexual medicine may be inhibited by a person's reluctance to disclose intimate or uncomfortable information. Even if such an issue is on the person's mind, he or she often doesn't start talking about such an issue without the physician initiating the subject by a specific question about sexual or reproductive health.[6] Some familiarity with the doctor generally makes it easier for person to talk about intimate issues such as sexual subjects, but for some people, a very high degree of familiarity may make the person reluctant to reveal such intimate issues.[6] When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.[6]
References
Literature
- Lipshultz LI, Khera M, Atwal DT. Urology and the Primary Care Practitioner. Philadelphia: Elsevier, 2008.
- Naomi Pfeffer: The Stork and the Syringe: A Political History of Reproductive Medicine (Feminist Perspectives) Polity Press 1993, ISBN 0-7456-1187-7
- Speroff L, Glass RH, Kase NG. Clinical Gynecologic Endocrinology and Infertility. Fifth Edition. Williams and Wilkins, Baltimore MD, 1994 ISBN 0-683-07899-2
